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Pennsylvania Opioid Summary

Revised March 2019

Opioid-Related Overdose Deaths

In 2017, there were 2,548 reported opioid-involved deaths in Pennsylvania—a rate of 21.2 deaths per 100,000 persons, compared to the average national rate of 14.6 deaths per 100,000 persons. In 2013, prescription opioids were the underlying cause of 1 in 2 drug overdose deaths. By 2017, the main contributer of opioid-involved deaths shifted to synthetic opioids other than methadone (mainly fentanyl). The state recorded a seventeenfold increase, from 108 reported deaths in 2013 to 1,982 deaths in 2017 (Figure 1). Opioid deaths involving heroin also rose during the same period to a peak of 926 deaths in 2016. In 2017, that number fell to 819 deaths, a decrease of more than 10 percent.

See textFigure 1. Number of overdose deaths involving opioids in Pennsylvania, by opioid category. Drug categories presented are not mutually exclusive, and deaths might have involved more than one substance. Source: CDC WONDER.

Opioid Pain Reliever Prescriptions

In 2017, Pennsylvania providers wrote 57.7 opioid prescriptions for every 100 persons (Figure 2) compared to the average U.S. rate of 58.7 prescriptions (CDC).  This represents more than a 30 percent decrease from a peak of 83.3 opioid prescriptions per 100 persons in 2012.

The rate of overdose deaths involving opioid prescriptions rose steadily from 0.7 deaths per 100,000 persons in 1999 to a peak of 5.9 deaths per 100,000 persons in 2016 (Figure 2). In 2017, 4.9 deaths per 100,000 persons were reported, signaling a downward trend.

See textFigure 2. Pennsylvania rate of overdose deaths involving prescription opioids and the opioid prescribing rate.  Source: CDC and CDC WONDER.

Neonatal Abstinence Syndrome (NAS)

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOWS births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).

To date, there is no standard in NAS/NOWS provider and hospital coding practices (CDC). As a result, the trends and rates reported by states varies. The number of NAS/NOWS cases in Pennsylvania totaled 1,912 in 2017. The rate of NAS/NOWS rose from 1.2 cases per 1,000 hospital births in combined fiscal year’s1 2000-2001 to 15.0 cases per 1,000 hospital births in combined fiscal year’s 2016-2017 (Pennsylvania Health Care Cost Containment Council).

See textFigure 3. NAS/NOWS Incidence rate and hospital costs for treatment in the United States. Source: T.N.A. Winkelman, et al., 2018.

HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)

See text Figure 4. Pennsylvania: Estimated percent of male vs. female with new HIV diagnoses, by transmission category, 2016. Source: CDC and www.AIDSVU.org.
  • U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among males, 6.3 percent (2,530) of new cases were transmitted via IDU or male-to-male contact and IDU. Among females, 2.3 percent (950) were transmitted via IDU (CDC).
  • U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,4661) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
  • State Incidence: Of the new HIV cases in 2016, 1,150 occurred in Pennsylvania. Among males, 9.1 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 11.9 percent of new HIV cases were attributed to IDU (Figure 4) (AIDSVu).
  • State Prevalence: In 2015, an estimated 34,233 persons were living with a diagnosed HIV infection in Pennsylvania—a rate of 314 cases per 100,000 persons. Of those, 25.5 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 26.7 percent were living with HIV attributed to IDU (AIDSVu).

Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use2

  • U.S. Incidence: In 2016, there were an estimated 41,200 new cases of acute HCV3 (CDC). Among case reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
  • U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
  • State Incidence: There were approximately 225 new cases of acute HCV (1.8 per 100,000 persons) reported in Pennsylvania in 2016 (CDC).
  • State Prevalence: In Pennsylvania, there are an estimated 95,100 persons living with Hepatitis C (2013-2016 annual average), a rate of 950 cases per 100,000 persons (HepVu).

The National Institute of Health Funds Center of Excellence in Pain Education

This is the logo for the NIH Pain Consortium: Centers of Excellence in Pain Education.

Pennsylvania is home to two of the eleven Centers of Excellence in Pain Education (CoEPEs): the University of Pennsylvania and the University of Pittsburgh. The CoEPEs act as hubs for the development, evaluation, and distribution of pain management curriculum resources for medical, dental, nursing, pharmacy and other schools to improve how health care professionals are taught about pain and its treatment.

Additional Resources

NIH RePORTER FY2018 NIH-funded projects related to opioid use and use disorder in Pennsylvania: 25

Notes

  1. Defined by the US Federal Government, starting on October 1, of a given year and ending on September 30, of the following year.
  2. Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
  3. Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.

This page was last updated March 2019

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